Maurizio Calcagni - University of Zurich, Switzerland
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Maurizio Calcagni
University of Zurich, Switzerland
English Departement
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Papers by Maurizio Calcagni
Intramedullary headless screw fixation for fractures of the proximal and middle phalanges in the digits of the hand: a review of 31 consecutive fractures
by
Andrea Poggetti
Giesen Thomas
, and
Maurizio Calcagni
We present the results of 26 patients with 31 consecutive displaced or unstable extra-articular f...
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We present the results of 26 patients with 31 consecutive displaced or unstable extra-articular fractures of
the base and shaft of the proximal and middle phalanges of the digits of the hand, treated over a period of
12 months with an intramedullary headless compression screw and early mobilization with no splinting. All
fractures healed with no major complications. Only one patient, who had a pathological fracture through an
enchondroma, required a tenolysis to improve the mobility of the finger. This technique seems to be technically
simple, effective and with few drawbacks.
Multizentrischer Riesenzelltumor der Sehnenscheide vom lokalisierten Typ an beiden Händen mit fokaler Infiltration der Strecksehne: Fallbericht und Literaturübersicht
Wir berichten ü ber das sehr seltene Vorkommen von multizentrisch Riesenzelltumoren der Sehnensch...
more
Wir berichten ü ber das sehr seltene Vorkommen von multizentrisch Riesenzelltumoren der Sehnenscheide vom lokalisierten Typ an beiden H ä nden mit einer fokalen Infi ltration der Strecksehne eines 39-j ä hrigen gesunden Mannes.
Klinisch relevante Differenzialdiagnosen
by
Maurizio Calcagni
and
Thomas Böni
Das "offene Bein" ist ein klinischer Befund, dem viele unterschiedliche Ursachen, und oft gleichz...
more
Das "offene Bein" ist ein klinischer Befund, dem viele unterschiedliche Ursachen, und oft gleichzeitig mehrere Ursachen zugrunde liegen können. Immerhin ein Viertel aller Patienten mit einem Ulcus cruris haben eine "ungewöhnliche" Ursache, das heißt, kein venöses, gemischt venös-arterielles oder arterielles Ulkus. Allein schon dieser hohe Anteil rechtfertigt zumindest an Zentrumsspitälern die Einrichtung einer interdisziplinären Wundsprechstunde, mit einem offenen Zugang für Patienten und Spezialisten im weiteren Einzugsgebiet. Die Koautoren dieses Beitrags konstituieren die interdisziplinäre Wundsprechstunde am Universitätsspital Zürich (Koordination: Dr. D. Mayer) und sind einhellig der Meinung, dass Patienten und ÄrztInnen von diesem fachlich breit abgestützten Ansatz nur profitieren können.
[Reconstruction of distal fingeramputations using palmar fingerflaps and the dorsal eponychial flap]
Handchirurgie · Mikrochirurgie · Plastische Chirurgie
Reconstruction of fingertip amputations, especially if they involve more than half of the fingern...
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Reconstruction of fingertip amputations, especially if they involve more than half of the fingernail require the surgeon to determine whether the fingernail should be removed. However, aside from aesthetic aspects the fingernail has functional purposes - stabilisation of the pulp and enhancement of sensibility - and should therefore be preserved. Since November 2004 we have been using the technique of combining palmar finger flaps with dorsal eponychial plasty in reconstructing complex distal fingertip defects in 12 patients. All flaps had an uneventful healing. One patient with insufficient bone support after a failed operation developed an onychogryphosis. The remaining patients were satisfied with the result. With a simple technique augmenting the palmar reconstruction of complex fingertip defects by the dorsal eponychial flap plasty we can achieve a better support for the pulpa and also a better cosmetic result.
Skin sensory regeneration in burn-injured patients. Review of the literature
Rivista Italiana di Chirurgia Plastica
ABSTRACT
Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen
ABSTRACT
The influence of progress in the treatment of severe burns on the quality of life
Acta chirurgiae plasticae
The problems related to burns treatment can be considered among the oldest and most passionating ...
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The problems related to burns treatment can be considered among the oldest and most passionating in history of medicine. Since the early forties amazing progresses have been done in the comprehension of the physiopathology of burns. The fast development of resuscitating techniques determined a remarkable reduction of mortality in the first phase; in a similar way through new concepts in the project and construction of intensive care facilities dedicated to burns, where patients can be isolated and a high standard of environmental control can be guaranteed, together with new topical and systemic antibacterial treatment protocols, a significant reduction of infectious complications has been achieved. Concerning surgical treatment early tangential excision and cultured epidermal grafts can be considered the cornerstones of burn therapy. Quality of life of burnt patients have been greatly ameliorated by these technical advances. Burn sequelae however remain the main concern of survivors because of the many controversial aspects of burn scar physiopathology and treatment. Along my career many endeavours I dedicated in this important research field. I will then report the results of most interesting clinical and experimental studies carried out in the last 30 years by our group in collaboration with basic researchers. All the work done in this domain enhance our hope that good results can really improve quality of life in burns: this is the goal for those who dedicated the whole life to relieve the suffering of these badly injured patients.
[Fibrolipohamartoma of the upper extremity: treatment results in six patients over nine years]
Handchirurgie · Mikrochirurgie · Plastische Chirurgie
Fibrolipohamartoma (FLH) is a rare, benign congenital malformation of peripheral nerves, mainly t...
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Fibrolipohamartoma (FLH) is a rare, benign congenital malformation of peripheral nerves, mainly the median nerve, less frequently of the ulnar or other nerves. Early symptom is an initially painless, slowly growing and circumscript swelling. Affections at the wrist level or the foot are occasionally accompanied by macrodactyly. Although FLH is a congenital disorder, because of absent or discreet symptoms, the diagnosis is often made in early adulthood only due to a compression neuropathy. Magnetic resonance image findings are pathognomonic, biopsies are not necessary. In the medical literature, FLH has been described for the past forty years only by means of case reports or small case series. Meanwhile, surgical decompression is considered as therapeutic gold standard, in case of an accompanying macrodactyly in combination with corrective procedures for length, breadth and axis. To study long term results after surgical compression of FLH und thus an assessment of this therapeutical concept generally accepted as gold standard in this rare entity. Between 1994 and 2004 we treated 9 patients (8 women, 1 man) with 11 tumors, average age was 38 years (3-62). 2 of the 9 patients had macrodactyly. In 7 patients, the median nerve was affected, in one patient bilaterally, in 5 patients the ulnar nerve, and in one patient both ipsilateral median and ulnar nerves. Of those 9 patients, we were able to follow up 6 clinically and electroneurographically. In addition, the DASH-score was collected. Average follow-up after initial decompression was 9 years (2-23). We performed surgical decompression in 5 patients, one patient was treated conservatively. Patients with affections of the median nerve showed tendentially better results after surgical decompression compared to those with FLH of the ulnar nerve, irrespective of the affected anatomical level. Surgical decompression led to a relief of the symptoms in all patients; an improvement of motor function, hypaesthesia and cold sensitivity, however, could not be demonstrated. FLH must be considered in the differential diagnosis of macrodactyly. We recommend surgical decompression, as it leads to relief of the symptoms. It does, however, not have a beneficial effect on already present motor impairments, sensory deficits and cold sensitivity. We strictly advise against tumor resection.
Sonographic Assessment of Morphology and Tendon Dynamics following Deep Flexor Tendon Repair in Zone II
PURPOSE To prospectively assess morphology and tendon dynamics of repaired deep flexor tendons of...
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PURPOSE To prospectively assess morphology and tendon dynamics of repaired deep flexor tendons of the hand in Zone II using high frequency ultrasound and to correlate sonographic findings with the clinical outcome. METHOD AND MATERIALS The study was approved by the local ethical committee and informed consent was obtained from each patient. 11 repaired flexor tendons in 10 patients (mean age 34 years, range 19-55 years) were examined clinically and with ultrasound on 7 follow ups over 3 month. Postoperative tendon morphology was assessed qualitatively and quantitatively with B-Mode and Power Doppler ultrasound. Tendon excursion was quantitatively assessed by sonographic thread-and-scar tracking. Total active motion of the finger was measured at each follow up and used as outcome parameter. Correlation of sonographic findings with the clinical outcome was performed. RESULTS A spindle-like shape was present in almost all tendons in the first postoperative week. During the follow up ti...
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Better clinical outcomes associated with spindlelike tendon shape and higher power Doppler signals suggest intrinsic healing patterns.
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Carpal tunnel syndrome: Analysis of online patient information with the EQIP tool
Chirurgie de la Main
Patients suffering from carpal tunnel syndrome (CTS) actively search for medical information on t...
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Patients suffering from carpal tunnel syndrome (CTS) actively search for medical information on the Internet. The World Wide Web represents the main source of patient information. The aim of this study was to systematically assess the quality of patient information about CTS in the Internet. A qualitative and quantitative assessment of websites was performed with the modified Ensuring Quality Information for Patients (EQIP) tool that contains 36 standardized items. Five hundred websites with information on CTS treatment options were identified through Google, Bing, Yahoo, Ask.com and AOL. Duplicates and irrelevant websites were excluded. One hundred and ten websites were included. Only five websites addressed more than 20 items; quality scores were not significantly different between the various providing groups. A median of 15 EQIP items was found, with the top website addressing 26 out of 36 items. Major complications such as median nerve injury were reported in 27% of the website...
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Out of 500 screened websites, only 110 were analyzed for quality, revealing a limited pool of reliable information.
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A new in vivo MRI method to non-invasively monitor and quantify the perfusion capacity of 3D-biomaterials grown on the chorioallantoic membrane of chick embryos
Adequate vascularization in biomaterials is essential for tissue regeneration and repair. Current...
more
Adequate vascularization in biomaterials is essential for tissue regeneration and repair. Current models do not allow easy analysis of vascularization of implants in vivo, leaving it a highly desirable goal. A tool that allows to monitor the perfusion capacity of such biomaterials non-invasively in a cheap, efficient and reliable in vivo model would hence add great benefit to the research in this field. We established, for the first time, an in vivo Magnetic Resonance Imaging (MRI) method to quantify the perfusion capacity of a model biomaterial, DegraPol® foam scaffold, placed on the embryonic avian chorioallantoic membrane (CAM) in ovo. Perfusion capacity was assessed through changes in the longitudinal relaxation rate before and after injection of a paramagnetic MRI contrast agent, Gd-DOTA (®Dotarem, Guerbet S.A.). Relaxation rate changes were compared in three different regions of the scaffold, i.e. at the interface to the CAM, in the middle and on the surface of the scaffold (p...
Treatment of Painful Nonunion of the Distal Phalanx in the Finger With Bone Graft and Dorsal Reverse Adipofascial Flap Based on an Exteriorized Pedicle
Techniques in hand & upper extremity surgery
, 2015
Reconstruction of the distal phalanx bone in cases with painful nonunion is a rare and challengin...
more
Reconstruction of the distal phalanx bone in cases with painful nonunion is a rare and challenging problem. To restore anatomy and to provide a good cover for the bone graft, an intact nailbed is often required due to the proximity of these 2 structures. We present 3 cases of distal phalanx reconstruction performed with a free corticocancellous bone graft from the distal radius and nailbed reconstruction with a homodigital dorsal reverse adipofascial flap based on an exteriorized pedicle that avoids the dissection of the germinal matrix of the nail. All bone grafts consolidated and all flaps survived. All nail plates grew back with no deformity. In this rare but challenging problem, our combined technique appears to be a valid option that enhances the possibility of good bone healing and maximizes the cosmetic result.
Flaps - general principles
Regional flaps – principles and specific flaps
The lateral arm free flap in lower extremity reconstruction
European Journal of Plastic Surgery
, 1997
Reconstruction of skin defects of the distal third of the leg and foot is often a difficult task....
more
Reconstruction of skin defects of the distal third of the leg and foot is often a difficult task. Shape, resistance to shearing stresses in the weight-bearing surface and sensibility are the main features that have to be restored. For coverage of this region, the authors have used, in selected patients, the lateral arm flap (LAF) since 1994. This flap is thin, easy to dissect and has the possibility to be innervated through the posterior cutaneous nerve of the arm. Fourteen cases are presented. The drawbacks of this flap are the loss of sensibility in the forearm (partially transient) and the scar on the arm, which can be rather unsightly in young ladies and when big flaps are harvested skin graft is needed.
Human Adipose-Derived Mesenchymal Stromal Cells May Promote Breast Cancer Progression and Metastatic Spread
Plastic and reconstructive surgery
, 2015
Stem cell-enriched fat grafting has been proposed as a potential therapy for reconstructive, rest...
more
Stem cell-enriched fat grafting has been proposed as a potential therapy for reconstructive, restorative, or enhancement-related procedures of the breast. Its role in postoncologic breast reconstruction is still emerging, with concerns about safety. The authors investigated the dose-dependent interaction between human adipose-derived mesenchymal stromal cells (AD-MSCs) and human breast cancer cell (BCC) lines [MDA-MB-231 (MDA) and MCF-7 (MCF)] focusing on tumor microenvironment, tumor growth, and metastatic spread. Adipose-derived mesenchymal stromal cell influence on viability and factor expression [regulated on activation, normal T cell expressed and secreted (RANTES), tumor necrosis factor-α, and eotaxin) of breast cancer cells was studied in vitro using direct and indirect co-culture systems. Groups were formed according to adipose-derived mesenchymal stromal cell-to-cancer cell number ratio [MDA/MCF only, AD-MSC/(MDA/MCF), and AD-MSC/(MDA/MCF)]. A humanized orthotopic murine ca...
Proteolytic activity and vascular changes during revascularization of skin grafts
Vascular Pharmacology
, 2012
LP18: PLATELET DERIVED SEROTONIN PLAYS A CRITICAL ROLE DURING SKELETAL MUSCLE ISCHEMIA AND REPERFUSION INJURY
Plastic and Reconstructive Surgery
, 2010
ABSTRACT An abstract is unavailable. This article is available as HTML full text and PDF.
Long-term clinical outcome after epineural coaptation of digital nerves
The Journal of hand surgery, European volume
, Jan 31, 2015
This study evaluates the long-term clinical outcome and complication rate after digital nerve rep...
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This study evaluates the long-term clinical outcome and complication rate after digital nerve repair in adults and aims to identify possible prognostic factors of sensory recovery. End-to-end epineural coaptation was performed under magnification. A total of 93 coapted digital nerves were clinically evaluated with a mean follow-up of 3.5 years (range 1-6 years). The mean two-point discrimination was 10.6 mm (versus 4.4 mm for the contralateral side). Cutaneous pressure threshold tested with Semmes-Weinstein monofilaments showed a mean value of 2.7 (versus 2.2 for the contralateral side). Only 2% of our patients developed painful neuromas. None of our patients recovered normal functional sensibility, however, recovery of protective sensation contributed to a high reported level of satisfaction. No correlation was observed between the sensory outcome and age, smoking, mechanism of injury, lesion to or anastomosis of a digital artery, or time of immobilization. The only identified pred...
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Mean two-point discrimination (s2-PD) was significantly worse on injured sides (10.6 mm) than uninjured (4.4 mm, p < 0.0001).
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Downregulation of miR-193b in systemic sclerosis regulates the proliferative vasculopathy by urokinase-type plasminogen activator expression
Annals of the rheumatic diseases
, Jan 10, 2014
To investigate the role of microRNA-193b-3p (miR-193b) in the vascular pathophysiology of systemi...
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To investigate the role of microRNA-193b-3p (miR-193b) in the vascular pathophysiology of systemic sclerosis (SSc). Expression of miR-193b in skin biopsies and fibroblasts from patients with SSc and normal healthy (NH) controls were determined by real-time PCR. Transfection with miR-193b precursor and inhibitor were used to confirm targets of miR-193b. Proliferative effects of urokinase-type plasminogen activator (uPA) were determined by water-soluble tetrazolium salt-1 assay and by analysis of proliferating cell nuclear antigen expression. Fluorescence activated cell sorting analysis was performed to investigate the effect of uPA on apoptosis. For inhibition of the uPA-cellular receptor for uPA (uPAR) pathway, uPAR neutralising antibodies and low molecular weight uPA were used. We found that miR-193b was downregulated in SSc fibroblasts and skin sections as compared with NH controls. The expression of miR-193b was not affected by major profibrotic cytokines and hypoxia. Induction o...
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